A cryptic pregnancy is when a woman is unaware that she is pregnant. Sometimes the woman will realize she is pregnant when she is in the third trimester or only when she goes into labor.
In this article, we discuss what to know about cryptic pregnancies, including symptoms, risk factors, and when to see a doctor.
Women with a cryptic pregnancy are unaware that they are pregnant. They may only realize they are pregnant during the last few weeks of pregnancy or when they give birth.
Recent studies on cryptic pregnancy are hard to come by. However, those available studies have suggested that cryptic pregnancies occur more often than doctors might think.
A 2011 review of available research finds that 1 in 475 women deny their pregnancy at 20 weeks or more.
Often, women with a cryptic pregnancy do not experience typical symptoms of pregnancy, such as:
- missed periods
- abdominal swelling
Doctors and relatives may also be unaware that the woman is pregnant.
Babies born from a cryptic pregnancy tend to be underweight, and the lack of prenatal care may affect their development.
Doctors classify most cryptic pregnancy as psychotic or nonpsychotic.
According to the 2011 review, women with psychotic denial of pregnancy may have mental illnesses, such as schizophrenia or bipolar disorder. They may experience symptoms of pregnancy but may link them to delusional causes.
Women with nonpsychotic denial have no history of mental illness and their sense of reality is intact.
Doctors separate nonpsychotic cryptic pregnancy into three categories:
Women with pervasive denial of pregnancy experience a lack of emotional significance to pregnancy and are unaware that they are pregnant.
Women with affective denial of pregnancy acknowledge they are pregnant but do not prepare emotionally or physically for pregnancy, childbirth, and parenting.
Doctors report that women with persistent denial become aware of pregnancy in the last trimester and avoid seeking medical attention.
Research reports that 36% of women with cryptic pregnancies have pervasive denial, 11% have persistent denial, and 52% have affective denial.
Women with cryptic pregnancies may not experience any typical pregnancy symptoms or only vague ones.
Doctors may need to consider that women of childbearing age with symptoms of pregnancy may be pregnant even if they deny it might be the case.
Women with a psychotic cryptic pregnancy may experience a variety of symptoms. One of the only symptoms that women with a nonpsychotic cryptic pregnancy may notice is an unexpected delivery.
Doctors may find it challenging to diagnose a cryptic pregnancy because symptoms may not be present or noticeable. Also, women may never consult a doctor during their pregnancy.
In some situations, women may have consulted a doctor during their cryptic pregnancy but not received a correct diagnosis.
By increasing awareness in healthcare providers, women experiencing cryptic pregnancy may have better access to medical care. This can help to improve outcomes for their baby.
According to the literature, researchers previously thought that women with cryptic pregnancies typically had one or more of the following factors:
- younger age
- learning disabilities
- poor social and family support
- mental illnesses
- history of drug abuse
It now seems that no clear indicators of cryptic pregnancy exist.
From the review of studies, the evidence now suggests that most women with cryptic pregnancies are:
- in their 20s
- have other children
- have good social and family support
Only a minority have lower intelligence, drug abuse, or mood and psychiatric disorders.
External stresses and mental or emotional conflicts around pregnancy may cause pregnancy denial in otherwise healthy women.
Doctors may find it challenging to identify women with pregnancy denying characteristics.
Pregnant women experiencing psychiatric disorders may be aware of their symptoms but deny they are real and link them to other causes.
Other women without mental illnesses may experience stress and conflicts about pregnancy, which can lead to cryptic pregnancy.
Doctors have yet to establish risk factors for cryptic pregnancy because they are unable to identify common features.
As the cryptic pregnancy progresses, doctors have a better chance of detecting pregnancy. The rate of cryptic pregnancy decreases from 1 in 475 pregnancies at 20 weeks to 1 in 2500 pregnancies when active labor begins.
Since women with cryptic pregnancies may only become aware of pregnancy in the later terms of pregnancy, they may experience emotional disturbances.
After giving birth, the women may disassociate from their baby, increasing the risk of abuse, child neglect, and death.
Women with cryptic pregnancies may have unassisted deliveries because they have not prepared for birth.
Denial of pregnancy and its complications put the baby at risk of:
- small size
Women with denied pregnancy may deliver unexpectedly, in some cases, giving birth without assistance.
Unassisted deliveries can be dangerous for both mother and child.
Many healthcare professionals report that unassisted childbirth is not safe, and medical attention is essential during delivery.
Women who are confident they are pregnant, despite having a negative pregnancy test, should speak with their doctor or another healthcare provider.
The most specific and accurate pregnancy test is a blood test. Doctors will check for the presence of human chorionic gonadotropin (HCG) in the blood. HCG is a hormone that the placenta releases.
If a woman follows the directions of an at-home urine pregnancy test correctly, the results are typically reliable.
Other situations may cause a false-negative result. This means people are pregnant, but the test gave a negative result.
Factors that can cause a false-negative result include:
- taking the test too early
- using diluted urine for a pregnancy test
- checking test results too soon
Certain medications can also affect the results of a pregnancy test, causing a false-positive result. This means the test shows positive for pregnancy when a woman is not pregnant.
Medications that affect pregnancy test results include:
- Parkinson’s disease drugs
- antianxiety medications
- antipsychotic medications
- fertility medications
Some brands of pregnancy tests are less reliable than others and their sensitivities may vary from test to test. The packaging of the at-home urine pregnancy test should indicate the test’s sensitivity.
If a woman believes she is pregnant, but the urine test is negative, she should test her urine again in a few days. If the test is still negative, she should speak with a doctor and request a blood test.
Any woman experiencing symptoms of pregnancy should consult with a doctor to confirm the diagnosis.
Women who are pregnant require prenatal care, and doctors may recommend dietary and lifestyle habits to promote a healthy pregnancy and baby.
Some psychiatrists suggest that the Diagnostic and Statistical Manual of Mental Disorders (DSM) should list cryptic pregnancy.
Defining this condition in the DSM would make it easier for doctors to diagnose and treat women with cryptic pregnancies while some women may require help for mental illness.
Increased awareness of cryptic pregnancies among doctors may help reduce these and improve outcomes.
Most women with cryptic pregnancies will take care of their babies after they are born. A few women may harm an infant, and, sometimes, cryptic pregnancy can be the first sign of a psychiatric condition.
Cryptic pregnancies are more common than doctors first thought. Experts have not yet found any common risk factors for the condition.
Cryptic pregnancies can affect women with and without psychiatric disorders.
Women with cryptic pregnancies may not have typical symptoms of pregnancy and may not consult a doctor during their pregnancy.
Doctors can find it challenging to diagnose and treat women with denied pregnancy. More awareness of the condition may help improve diagnosis and outcomes.